Orthopedic soft tissue surgery covers a wide range from incisions to high-energy trauma. The damage caused by the initial injury or pathology cannot be changed, but additional trauma can be reduced by following soft tissue principles during surgery. Because of this diversity, it is important for every orthopedic surgeon to have a basic knowledge of soft tissue management. Understanding and applying this basic knowledge minimises complications in soft tissue surgery and ensures successful outcomes. Soft tissues consist of skin, subcutaneous fat, fascia, muscle-tendon units, ligaments, periosteum and neurovascular structures. The epidermis and dermis act as a barrier against infection and preservation of blood flow prevents complications. Principles should be considered before and during surgery: Open wounds should be irrigated and foreign bodies should be removed to prevent infection. Povidone-iodine and chlorhexidine can be used for skin cleaning. The surgical field should be cleaned with appropriate solutions and incision should be made after complete drying. Povidone-iodine and chlorhexidine are commonly used, but iodine solutions should be avoided in open wounds and in contact with bone. Tourniquets reduce bleeding, but may lead to complications when used incorrectly. Tourniquet time is limited to 1.5 hours and should not exceed two hours. The pressure differs for upper and lower extremities and is adjusted according to the patient`s blood pressure. When planning the incision, the smallest incision that will provide the sufficient view should be preferred. The surgical set and instruments should be carefully selected to minimise damage and stretching of the skin and all other tissues and at the same time provide adequate approach for surgery.